目的 分析口腔种植修复和常规修复在牙列缺损治疗中的有效性。方法 选定本院2019年1月—2020年12月接诊的120例牙列缺损患者,根据修复治疗方法的不同分组,参照组60例患者采取常规修复治疗,实验组60例患者采取口腔种植修复,比较两组临床疗效、龈沟炎症因子水平、并发症发生率、满意度评分。结果 实验组临床总有效率(96.67%)高于参照组(78.33%),实验组治疗后龈沟TNF-α、IL-8、IL-6因子均低于参照组,实验组并发症发生率(1.67%)低于参照组(13.33%),实验组患者满意度评分均高于参照组,差异均有统计学意义(P＜0.05)。结论 口腔种植修复可有效改善牙列缺损患者语言、咀嚼功能,减轻龈沟炎症反应,减少并发症,提高患者满意度。

Objective To analyze the efficacy of dental implant and conventional repair in the treatment of dentition defects. Methods A total of 120 patients with dentition defects in our hospital from January 2019 to December 2020 were selected and divided into two groups according to different treatment methods. Sixty patients in the control group were treated with conventional repair, and 60 patients in the experimental group were treated with dental implant repair. The clinical efficacy, gingival crevicular inflammatory factors level, complication incidence and satisfaction score of the two groups were compared. Results The clinical efficacy of the experimental group (96.67%) was higher than that of the control group (78.33%), the levels of TNF-α, IL-8 and IL-6 in the gingival sulcus of the experimental group were lower than those of the control group after treatment, the complications incidence of the experimental group (1.67%) was lower than that of the control group (13.33%), and the satisfaction score of the experimental group was higher than that of the control group, the differences were statistically significant (P＜0.05). Conclusion Dental implant repair could effectively improve the language and chewing function of patients with dentition defects, reduce gingival crevicular inflammatory reaction, complications and improve patients' satisfaction.

目的 分析河源市学龄前儿童发生小细胞低色素性贫血的病因。方法 对我院进行健康体检小细胞低色素性贫血儿童287例进行血常规、血清铁蛋白及地中海贫血基因检测。结果 在所研究的287 例小细胞低色素性贫血儿童病例中,分别检出 α地中海贫血 127例,β地中海贫血 48例,α/β复合地中海贫血2例;铁缺乏 83例 (合并地中海贫血20例, 缺铁性贫血45例),不明原因贫血47例。地中海贫血检出率为61.67%,铁缺乏检出率为21.95% 。结论 地中海贫血是河源市学龄前儿童发生小细胞低色素性贫血最主要的原因,其次是铁缺乏,各年龄段儿童以轻度贫血为主,6月~1岁,1~3岁为铁缺乏高发年龄。α地中海贫血基因型以--^SEA/αα最常见,β地中海贫血以βIVS-II-654/β^N最常见,小细胞低色素症在静止型最常见。

Objective To analyze the causes of microcytic hypochromic anemia in preschool children in Heyuan City. Methods A total of 287 cases with microcytic hypochromic anemia were selected in our hospital. The indexes of hematology, serum ferritin were detected and genetic testing for thalassemia was performed. Results Through genetic analysis, 127 of 287 cases of microcytic hypochromic anemia were confirmed with α-thalassaemia,48 cases with β-thalassaemia,2 cases with compound α/β-thalassaemia and 83 cases with iron deficiency (20 thalassemia cases and 45 iron deficiency anemia cases). Thalassaemia detection rate was 61.67%, iron deficiency detection rate was 21.95%. Conclusion Thalassaemia was the main reason of microcytic hypochromic anemia in preschool children in Heyuan City, followed by iron deficiency. The mild anemia was the main type among all age groups, children aged 0.5-3 had higher iron deficiency rate. The main type of α-thalassaemia was --^SEA/αα, the main type of β-thalassaemia was βIVS-II-654/β^N and the main type of microcytic hypochromic was static type.

目的 回顾性分析因化疗需要行完全植入式输液港的乳腺癌患者相关血栓形成的因素。方法 收集广州市第一人民医院乳腺外科2018年5月—2019年4月期间行植入式输液港置入术的60例乳腺癌患者相关资料,采用SPSS 26.0软件进行统计学分析。结果 输液港相关血栓形成(catheter related thrombosis,CRT)发生率为21/60(35%)。BMI≤24的患者CRT发生率为30.3%,BMI＞24则为40.74%;行4、6、8次化疗的CRT发生率分别为20%、33.34%、44.12%,导管末端位于T5-T8的CRT发生分别为:66.67%, 26.09%, 28.57%, 50%;Ki-67高表达的血栓发生率为27.5%,低Ki-67表达则为50%;导管材质为聚氨酯的血栓发生率为47.62%,硅胶材质则为28.21%,但差异均无统计学意义(P＞0.05)。雌激素受体/孕激素受体(estragen receptor/progesterone receptor,ER/PR)阴性的CRT发生率为60%,ER/PR阳性则为23.8%(P＜0.05);人表皮生长因子受体-2(human epidermal growth factor receptor-2,HER-2)阳性CRT发生率为50%,HER-2阴性CRT发生率则为23.53%(P＜0.05)。多因素分析:相对于ER/PR阳性,ER/PR阴性将增加CRT的发生(OR=4.482, 95%CI:1.116～17.998, P＜0.05);Ki-67的表达对血栓形成的影响具有统计学意义(OR=7.051, 95%CI:1.513～32.858, P＜0.05);HER-2表达对CRT的形成均无统计学意义(OR=0.254,95%CI:0.058～1.115, P＞0.05)。结论 血栓形成是植入式输液港术后常见的并发症,与肿瘤ER/PR表达相关,临床上应得到重视。

Objective To analyse the factors that lead to venous thrombosis among breast cancer patients who need totally implantable access port(TIAP) for chemotherapy. Methods Collecting the clinical data of 60 breast patients admitted to Guanzhou First People's Hospital from May 2018 to April 2019, analysed with SPSS 26.0. Results Catheter-related thrombosis(CRT) occurred in 21 out of 60(35%) patients with TIAP. 30.3% patients with BMI≤24 and 40.74% patients with BMI＞24 had CRT, and incidences of CRT were 20%, 33.34%, 44.12% at the fourth, sixth, eighth therapy respectively. The access terminal position at T5-T8 had 66.67%, 26.09%, 28.57%, 50% of incidence for CRT respectively. 27.5% CRT was with high Ki-67 expression and 50% CRT was with low Ki-67 expression; 47.62% patients with polyurethane catheter and 28.21% patients with silicone catheter got CRT. There were no significant differences in the comparisons above. CRT incidence in ER/PR negative patients was 60%,while 23.08% in ER/PR positive patients (P＜0.05). In HER-2 positive and negative patients, the incidences of CRT were 50% and 23.53% (P＜0.05). Logistic regression noticed that ER/PR negative would increase the incidence of CRT(OR=4.482, 95%CI:1.116～17.998, P＜0.05), low Ki-67 expression would accelerate CRT(OR=7.051, 95%CI:1.513～32.858, P＜0.05). There was no significant difference in the formation of CRT with HER-2 expression(OR=0.254, 95%CI:0.058～1.115, P＞0.05). Conclusion CRT was a common complication of TIAP, which related with ER/PR expression, and should pay attention to during clinical practices.

目的 分析妊娠期糖尿病(gestational diabetes mellitus,GDM)孕妇接受胰岛素治疗对妊娠结局的影响及安全性。方法 将2018年7月—2020年7月接诊且行常规治疗的50例GDM孕妇作为对照组,将同期接诊且在对照组基础上行胰岛素治疗的50例GDM孕妇作为观察组,对组间血糖控制效果、生活质量(SF-36)、治疗效果、不良妊娠结局、不良反应展开分析。结果 (1)组间血糖指标在治疗前无明显差异(P＞0.05);治疗后,观察组血糖控制效果优于对照组(P<0.05);(2)观察组SF-36评分高于对照组,且治疗效果(96.00%)优于对照组(82.00%,P<0.05);(3)观察组出现3例不良妊娠结局(6.00%),对照组出现11例不良妊娠结局(22.00%,P<0.05);(4)观察组发生3例不良反应(6.00%),对照组发生2例不良反应(4.00%,P＞0.05)。结论 对GDM孕妇实施胰岛素治疗,可以改善孕妇血糖水平,减少不良妊娠结局,提高孕妇生活质量,安全可靠,值得推广。

Objective To analyze the effect and safety of insulin therapy on pregnancy outcome in pregnant women with gestational diabetes mellitus (GDM). Methods A total of 50 pregnant women with GDM who received conventional treatment from July 2018 to July 2020 were induded in the control group, and 50 pregnant women with GDM who received insulin treatment on the basis of the control group were induded in the observation group. Results (1) There was no significant difference in blood glucose index between two groups before treatment(P＞ 0.05); after treatment, the blood glucose control effect of the observation group was better than that of the control group(P<0.05); (2) SF-36 score of the observation group was higher than that of the control group, and the treatment effect (96.00%) was better than that of the control group (82.00%,P<0.05); (3) there were 3 cases of adverse pregnancy outcomes (6.00%) in the observation group and 11 cases (22.00%) in the control group; (4) there were 3 cases of adverse reactions (6.00%) in the observation group and 2 cases (4.00%) in the control group(P＞ 0.05). Conclusion Insulin therapy for pregnant women with GDM could improve the blood glucose level of pregnant women, reduced adverse pregnancy outcomes, improved the quality of life of pregnant women, which is safe and reliable, and is worthy of promotion.

目的 通过生物信息学方法,分析阿司匹林抗结直肠癌的作用机制。方法 在DrugBank 5.1.5中查找阿司匹林的直接作用蛋白靶点(direct protein targets,DPTs);构建阿司匹林DPTs的蛋白质-蛋白质相互作用(protein-protein interaction,PPI)网络并分析相关信号通路;从GEO数据库中获取结直肠癌表达谱芯片数据,筛选中心度最高的20个结直肠癌差异表达基因作为Hub基因;将DPTs相互关联基因与结直肠癌Hub基因求交集,确认阿司匹林抗结直肠癌的潜在作用靶点,分析其在TCGA数据库结肠腺癌样本中的表达情况,并进行GO功能富集分析和KEGG信号通路分析。最终通过RT-PCR和WB实验验证阿司匹林抗结直肠癌的潜在靶点。结果 在DrugBank 5.1.5中确定了11个阿司匹林DPTs,KEGG信号通路分析发现其中6个DPTs(EDNRA,IKBKB,NFKB2,NFKBIA,PTGS2,TP53)与癌症的发生发展有关。将DPTs相关联基因与筛选的20个结直肠癌Hub基因求交集,发现5个基因(CDK1,AURKA,CCNB1,MAD2L1,TPX2)可能是阿司匹林抗结直肠癌的潜在作用靶点,其在TCGA数据库结肠腺癌样本中均表达上调,基因功能主要富集于细胞周期调控。RT-PCR和WB实验结果显示阿司匹林可以降低人结肠癌细胞中CDK1,AURKA,CCNB1,MAD2L1,TPX2的mRNA水平和蛋白表达。结论 CDK1,AURKA,CCNB1,MAD2L1,TPX2可能是阿司匹林抗结直肠癌的潜在靶点,其可能通过影响细胞周期调控发挥抗肿瘤作用。

Objective To analyze the mechanism of aspirin against colorectal cancer(CRC)by bioinformatic analysis. Methods DrugBank 5.1.5 was used to identify direct protein targets (DPTs) of aspirin. The protein-protein interaction (PPI) network of DPTs was constructed and involved signaling pathways were analyzed. CRC-associated gene expression datasets were downloaded from GEO database, and the top twenty differentially expressed genes with the highest degree were screened out as Hub genes. Common genes between the genes associated with the DPTs and the Hub genes of CRC were the potential targets of aspirin against CRC. The potential targets in TCGA database colon adenocarcinoma (COAD) samples were examined. GO functional enrichment analysis and KEGG signaling pathway analysis of the potential targets were performed. The potential targets of aspirin against CRC cells were verified by reverse transcription-polymerase chain reaction (RT-PCR) and western blot (WB). Results Eleven DPTs of aspirin were identified in DrugBank 5.1.5. KEGG signaling pathway showed that 6 genes (EDNRA, IKBKB, NFKB2, NFKBIA, PTGS2, TP53) were associated with the occurrence and development of CRC. By intersecting 20 Hub genes of CRC with genes associated with the DPTs of aspirin, it was found that 5 genes (CDK1, AURKA, CCNB1, MAD2L1, TPX2) might be the potential targets of aspirin against CRC. They were all up-regulated in TCGA-COAD samples, and the gene functions were mainly enriched in cell cycle regulation. The results of RT-PCR and WB showed that aspirin could down-regulate the mRNA and protein expression levels of CDK1, AURKA, CCNB1, MAD2L1 and TPX2 in human colon cancer cells respectively. Conclusion CDK1, AURKA, CCNB1, MAD2L1 and TPX2 could be potential targets of aspirin against CRC by affecting the progress of cell cycle regulation.

目的 探讨甲状腺Bethesda Ⅲ类(AUS/FLUS)结节的诊断原因,以及亚分类在预测结节恶性风险(risk of malignancy,ROM)中的价值。方法 收集356例Bethesda Ⅲ结节患者,对其诊断原因, ROM及亚分类进行总结分析。结果 在97例手术切除标本中,72例恶性肿瘤均为甲状腺乳头状癌(papillary thyroid carcinoma,PTC),Bethesda Ⅲ类的ROM为74.2%。影响PTC诊断的主要原因有病灶小、穿刺细胞量稀少、缺乏乳头状结构及细胞核特征不典型;次要原因有间质显著纤维化或钙化、涂片不合格、固定不当、染色不佳及细胞学诊断经验欠缺等。Bethesda Ⅲ类的亚分类:132例为低风险组,其中12例手术切除,ROM为8.3%;122例为高风险组,其中70例手术切除,ROM为92.9%;102例为中风险组,其中15例手术切除,ROM为40.0%;高风险组和低/中风险组之间的差异有统计学意义(P＜0.05)。结论 Bethesda Ⅲ类的诊断具有一定的主观性和经验性,而对Bethesda Ⅲ类结节进行风险相关的亚分类,有助于实现更好的ROM分层并改善此类病变的临床管理。

Objective To investigate the diagnostic causes of Bethesda Ⅲ (AUS/FLUS) thyroid nodules and the value of subcategories in predicting risk of malignancy (ROM) of thyroid nodules. Methods The data of 356 cases of Bethesda Ⅲ nodules were collected, and the causes, ROM and subcategories were summarized. Results In 97 resected specimens, 72 were diagnosed as papillary thyroid carcinoma (PTC), and the ROM of Bethesda Ⅲ was 74.2%. The main factors affecting the diagnosis of PTC were small lesions, few puncture cells, atypical nuclear features and lack of papillary structure. Secondary factors included significant interstitial fibrosis or calcification, unqualified smear, improper fixation, poor staining and lack of cytological diagnosis experience. According to the subcategories of Bethesda Ⅲ, 132 cases were included in low-risk group, nodules of 12 cases in the group were resected, which ROM was 8.3%; 122 cases were included in high-risk group, nodules of 70 cases were resected, which ROM was 92.9%; 102 cases were included in middle-risk group, nodules of 15 cases were resected, which ROM was 40.0%. The differences between high-risk group and low/medium-risk group were statistically significant (P＜0.05). Conclusion The diagnosis of Bethesda Ⅲ is subjective and empirical in some degree, and the risk related subcategories of Bethesda Ⅲ nodules is helpful to achieve better ROM stratification and improve the clinical management of the disease.

目的 对3例儿童Rotor综合征的临床特点及SLCO1B1和SLCO1B3基因突变分析,提高儿科医生对Rotor综合征的认识。方法 收集广州市妇女儿童医疗中心2018年—2019年确诊的3例Rotor综合征患儿的临床资料,对患儿及其家系成员肝脏常见遗传代谢性疾病二代测序筛查并家系验证结果进行分析。结果 患儿主要临床表现为反复或持续巩膜和(或)皮肤轻度黄染,实验室检查提示高直接胆红素血症。二代测序发现3例患儿均为SLCO1B1基因c.1738C＞T纯合突变和SLCO1B3基因5号内含子区域大片段插入纯合突变。SLCO1B1基因和SLCO1B3基因2处纯合突变均进行了家系验证。文献报道的SLCO1B1基因c.1738C＞T突变是无义突变,可以造成蛋白功能缺失;SLCO1B3基因的大片段插入突变虽暂未有文献收录或报道,但大片段的插入突变可引起移码突变而造成编码蛋白功能丧失。结论 由于基因检测技术的不断进步,Rotor综合征不断被儿科医生所认识。SLCO1B1和SLCO1B3双基因纯合或复合杂合突变是3例Rotor综合征患儿的分子遗传基础。

Objective To better understand Rotor syndrome(RS)in children,the clinical features and SLCO1B1 and SLC01B3 gene mutations were analyzed. Methods The clinical data of the 3 pediatric cases diagnosed in Guangzhou Women and Children's Medical Center between 2018 and 2019 was collected. Genomic DNA was extracted from the children and their family members, and subjected for second-generation sequencing to screen the known genes for liver genetic metabolic diseases. Then the detected mutations were confirmed by Sanger sequencing analysis. Results The main clinical manifestations were recurrent or persistent mild yellowish sclera and/or skin. Laboratory examinations showed hyperbilirubinemia with direct bilirubin elevating. Second generation sequencing showed that all 3 children were c.1738c＞Thomozygous mutations of SLCO1B1 gene and homozygous mutations of large fragment insertion in SLCO1B3 gene intron 5. Two homozygous mutations in SLCO1B1 gene and SLCO1B3 gene were verified in families.SLCO1B1 gene c.1738C＞T mutation,a nonsense mutation reported in references,could lead to protein function loss.A large insertion mutation of SLCO1B3 gene could cause frame-shift mutation which might lead to protein function loss even though it was neither reported in the references nor recorded in SNP database. Conclusion Due to the progress in the clinical application of gene detection technology, RS has been recognized gradually by pediatricians. Homozygous mutations or compound heterozygous mutations simultaneously occurred in SLCO1B1 and SLCO1B3 gene were the molecular genetics base in these cases of RS.

目的 探讨婴儿过敏性直肠结肠炎的临床特点及肠镜、肠黏膜病理特点。方法 回顾性分析2016年1月—2018年12月我院收治的110例婴儿过敏性直肠结肠炎的临床资料及其结肠镜、肠黏膜病理结果、食物过敏原特异度IgG、血常规、粪常规、血清总IgE检测及治疗情况。结果 110例过敏性直肠结肠炎中男67例,女43例,< 6月龄98例;单纯母乳喂养26例,单纯牛奶喂养19例,混合喂养65例;临床表现均有腹泻,大部分患儿伴有血便(93例),部分患儿伴湿疹(23例)、排便哭闹(67例)、夜眠不安稳(61例)、呕吐(8例)、营养不良(6例);血嗜酸性粒细胞升高63例;血清总IgE升高21例;食物过敏原特异度IgG检测结果,牛奶103例,鸡蛋62例;内镜下病变均累及降结肠、乙状结肠、直肠,累及横结肠76例、升结肠47例、回盲部18例;最常表现为疱疹样改变(106例)、糜烂(97例)、溃疡(13例),组织病理学表现为肠黏膜嗜酸性粒细胞浸润91例,隐窝炎、隐窝增生21例,淋巴滤泡形成18例、浅表溃疡形成4例;18例经母亲规避饮食后好转,8例经先换用氨基酸奶粉喂养1周、再逐渐引入母乳后好转;19例换用深度水解或氨基酸奶粉喂养后好转;65例经换用深度水解或氨基酸配方奶粉喂养、同时母亲规避饮食后好转。结论 婴儿过敏性直肠结肠炎缺乏特异度表现,多数临床经过良好,仅少数并发营养不良;牛奶是最主要的过敏原;腹泻、便血病史、血嗜酸细胞升高、肠镜疱疹样改变、肠黏膜嗜酸细胞浸润,提示过敏性直肠结肠炎可能性大;母亲规避饮食或换用氨基酸或深度水解奶粉治疗有效,也是确诊的标准。

Objective To investigate the clinical features of infantile allergic proctocolitis and its endoscopic lesions and pathological features. Methods A retrospective analysis of 110 cases of infantile allergic proctocolitis admitted to our hospital from January 2016 to December 2018 and its colonoscopy and pathological results, food allergen-specific IgG, blood routine, fecal routine, serum total IgE detection and treatment. Results Among 110 patients with allergic proctocolitis, 67 were male and 43 were female, 98 were < 6 months old; 26 were breastfed exclusively, 19 were fed milk alone, and 65 were mixed feeding. The clinical manifestations were diarrhea, most of children with bloody stools (93 cases), some children with eczema (23 cases), defecation and crying (67 cases), restless sleep (61 cases), vomiting (8 cases), malnutrition (6 cases); blood eosinophils increased in 63 cases,serum total IgE increased in 21 cases. Food allergen-specific IgG test results:103 cases of milk, 62 cases of eggs. Endoscopic lesions involved the descending colon, sigmoid colon, rectum, 76 cases of transverse colon, 47 cases of ascending colon and 18 cases of ileocecal. Most common manifested as herpes-like changes (106 cases), erosion (97 cases), ulcers (13 cases). Histopathology showed 91 cases of intestinal mucosal eosinophil infiltration, 21 cases of cryptitis and crypt hyperplasia, 18 cases of lymphoid follicle formation and 4 cases of superficial ulcer formation. 18 cases were improved after the mother evaded diet. 8 cases were improved by feding with amino acid milk powder for one week, and then breast milk was gradually introduced; 19 cases were improved after switching to deep hydrolysis or amino acid milk powder. 65 cases were improved after switching to deep hydrolysis or amino acid milk powder and simultaneously the mother evaded diet. Conclusion Infantile allergic proctocolitis lack of insufficient specific manifestations, most of the clinical cases are good, only a few are complicated by malnutrition. Milk is the most important allergen. Diarrhea, history of blood in the stool, elevated blood eosinophils, intestinal herpes-like changes, bowel mucosal eosinophil infiltration, are suggesting a high possibility of allergic proctocolitis. Mothers avoiding diet or switching to amino acids or deep hydrolyzed milk powder treatment is also effective, and this is also the standard of diagnosis of proctocolitis.

目的 探讨以家庭为中心的患教模式对糖尿病患者代谢控制水平的影响。方法 选取168例2016年9月—2017年8月在我院治疗的糖尿病患者,根据不同的健康教育模式干预将其分为观察组和对照组,每组各84例。对照组患者采用传统的综合患教模式,观察组患者在对照组的基础上采用以家庭为中心的患教模式,比较两组患者的自我管理水平及血糖、血脂控制效果。结果 干预后,观察组自我管理总得分、饮食控制、运动锻炼、血糖监测、足部护理、高低血糖处理均优于对照组(P＜0.05);观察组的FBG、PBG、HbA1C、TC、TG、LDL-C水平均低于对照组(P＜0.05)。结论 以家庭为中心的患教模式可辅助患者规范自己的行为,加强自我管理,改善血糖控制水平。

Objective To study the effects of two health education models on the level of metabolic control in diabetic patients. Methods 168 patients with diabetes admitted to our hospital from September 2016 to August 2017 were selected as subjects. According to different health education model interventions, they were divided into observation group and control group, with 84 cases in each group. The patients in the control group adopted a comprehensive health education model, and the patients in the observation group adopted a family-centered health education model based on the control group. The self-management level and blood glucose and blood lipid control effects of the two groups were compared. Results After intervention, the observation group self-management total score, diet control, exercise, blood glucose monitoring, foot care, high and low blood glucose treatment were better than that of control group (P<0.05); observation group FBG, PBG, HbA1C, TC, TG, LDL-C level were lower than that of the control group (P<0.05). Conclusion A family-centered health education model may help patients regulate their behavior, strengthen self-management, and improve their blood sugar control levels.

目的 运用DRG分析临床路径管理对患者住院费用的影响。方法 采用BJ-DRGs分组器,选取2016年广州某三级综合医院的出院患者病案首页信息及DRG分组信息,对比是否实施临床路径管理对患者的总体住院费用影响及各DRG组的住院费用差异。结果 路径组中位住院费用为9 239.41元,低于对照组的12 358.06元,差异有统计学意义(P<0.001)。费用构成分析发现,路径组的治疗费、检查费、药品费、手术费和其他费低于对照组,而材料费用相对较高。比较的14个DRG组中,6个DRG组的路径组住院费用低于对照组。结论 实行临床路径管理可降低患者住院费用、改变费用构成。结合DRG积极推进临床路径精细化管理,可有效控制病种成本,遏制医疗费用的不合理增长。

Objective Using DRG to analyze the impacts on inpatient costs of a hospital in Guangzhou as incurred by clinical pathway management. Methods As performed by BJ-DRGs, we selected DRG grouping information and medical record homepage information of the inpatients discharged from a tertiary hospital in Guangzhou in 2016. Then we compared the impacts of clinical pathway management on overall inpatients costs and the difference of inpatient costs for the DRG group. Results The median of inpatient costs in the clinical pathway group was 9239.41 yuan, was lower than that of control group which was 12358.06 yuan, and the difference was statistical difference (P<0.001). Cost composition analysis found that the costs of treatment, examination, medicine, surgery and the others in the clinical pathway group were much lower than that of the control group, while the cost of materials was relatively high. Among the 14 DRG group study, there were 6 DRG groups which the inpatient costs of the clinical path group was obviously lower than the control group. Conclusion The implementation of clinical pathway management may reduce the inpatient costs and change the makeup of costs. Therefore, combining with DRG, we actively promote the refined management of clinical pathway, which may effectively control the costs of diseases and the unreasonable growth of medical expenses.